Adverse Reactions to Biologic Medications Used in Allergy and Immunology Diseases
October 2022
in “
Current Allergy and Asthma Reports
”
Omalizumab Mepolizumab Reslizumab Benralizumab Dupilumab Tezepelumab Rituximab Anti-TNF biologics skin testing in vitro tests anti-drug antibody detection ELISA ImmunoCAP assays Drug Challenge Testing Rapid Drug Desensitization Xolair Nucala Cinqair Fasenra Dupixent Tezspire Rituxan anti-tumor necrosis factor biologics enzyme-linked immunosorbent assay ImmunoCAP drug challenge test rapid drug desensitization
TLDR Biologic therapies can cause various adverse events, but allergy/immunology clinicians can manage them.
The document reviews adverse reactions to biologic medications used in allergy and immunology, affecting up to 77% of patients starting certain biologics. These reactions are classified into five types and include acute infusion reactions, injection site reactions, cytokine release reactions, and delayed reactions. Diagnostic strategies include skin testing, in vitro tests, anti-drug antibody detection using ELISA and ImmunoCAP assays, and Drug Challenge Testing. The document cites a study involving 95 patients for Drug Challenge Testing, where 47 of the 60 who completed the challenge had no reactions. It also mentions a retrospective study involving 526 desensitizations where 77% completed the Rapid Drug Desensitization procedure without reaction. The document also discusses adverse drug reactions to specific agents, such as Omalizumab, Mepolizumab, Reslizumab, Benralizumab, Dupilumab, Tezepelumab, Rituximab, and Anti-TNF biologics. The document concludes that while biologic therapies have revolutionized treatment, they can cause a spectrum of adverse events, and allergy/immunology clinicians are well-positioned to manage these reactions.
